Hello, ladies and gents Robert Sykes, keto, Savage.com today. Haven't got special guest dr. Tracy gabbing on the line dr. Gavin is all about performance male performance, especially when it comes to improving improving. All facets of your health. From like an environmental standpoint removing toxins. Improving Your Sleep Quality improving your hormonal panel. So we dive deep into all things, Mayo Performance, Health Vitality, just optimization
human optimization. So I thoroughly enjoyed the conversation. Learned a ton, have no doubt that you will take something from this. So without further Ado, sit back relax and do the podcast with dr. Tracy Gabon and we are Live. Tracy. How are you man? And are great. Good to see you likewise likewise. So I want to dive in. I feel like I've had a several podcast guests as of Talking all about female performance enhancement. Let's talk about male
performance enhancement. So that's probably more. So your area of expertise. Yeah. Background is in urology originally, right? Yeah, exactly. I spent 20 plus years in traditional medicine as a clinical urologist, very busy practice. Doing a lot of robotic surgery and kidney stone work. And big open, cases and spending
half my life at the hospital. And I found this world all the health optimization and Human Performance and Longevity through some health issues of my own, that really transformed the way I look at health. And the way I look at, you know, how we approach it and taking a very different perspective than what I was taught in medical school. And, and that led me down the path.
I am now where I launched the Gap Institute, so I can focus on optimization and performance An awesome when you are working in like the traditional clinical setting. Yeah. What were some common common factors? You were saying? I'm assuming like you see so many patients a day you probably start to realize some common denominators. Yeah, definitely. Common patterns, you know, I'd see so many men come in, and it's the typical picture of the guys at a busy. Busy in a professional, he's an
attorney. He's a wealth, advisories and accountant, he's a business owner, he's some sort of sort of busy entrepreneur. And And the guys in his mid-50s or so, he has the big belly. The belly fat, he's got brain fog, he has low energy, low fatigue, fatigue, low morale. Loss of confidence. Not sleeping well, eating like crap, not exercising stressed out. It's the typical middle aged guy picture that you can imagine.
And what's what's kind of funny is they all come in for the same reason and that is Doc, I'm having trouble in the bedroom and that's what fun. Gets the retention. And that's kind of what's wrong with our entire Health Care system because we don't have health care. We have disease care Crisis Care.
I call it where the only time someone goes to the doctor especially man is one of those are problem and for men it's got to be a big problem that's typically around sex and so that's when guys can to come in and and that's when we can start diving deep into you know metabolic health and nutrition in genetics and peptides and all the fun stuff that we do to individualize health for That guy when you when you're sitting there and talking with these with these patients, are they
are they? You know, conscious of the fact that all of their environmental factors and their stress levels at all these things are taking a toll, are they totally oblivious to just those simple dots that need to be connected? Yeah. Good question.
They're typically problem unaware that they have no idea of, you know, I look at seven general areas of health and and they're unaware of all of them, except for testosterone and They'll come in and they'll be like, hey Doc I think I need some testosterone and that's kind of helping start and maybe the last for the blue pill as well, but they have no understanding of the endocrine disruption.
The toxins in our environment that you alluded to no idea about how to implement, you know, an appropriate nutrition and fitness plan strategy, no idea how to mitigate the effects of unbridled chronic stress. No idea.
Really had a focus on proper sleep mindset, you know, all these aspects of Healthier, so important and most guys, I work with initially, they just don't have much understanding of any of it. Yeah, I'd be curious to get your take on it but I would imagine in ranking like the hierarchy of what people what steps people should take to improve, you know, they're, they're foundational Health around these, these topics, they probably should.
Look testosterone is the last addition to the equation. Yeah, exactly. You know it's one piece of a bigger picture and I emphasize what's known as a systems biology approach to health understanding that we are these complex human systems and there are a ton of inputs into the system that ultimately affect the outcome and whenever you try to focus on one single aspect of it it doesn't work. You know like for example guys will come in say yeah I'm
feeling like crap. But I've been doing intermittent fasting for two weeks and it's just not working. So I'm just I need help. And I'm like, what have you done any of these other 20 or 30 things that I think are important as well? Well, no, but I tried intermittent fasting a clue. It doesn't work that that's the, the, the simple-minded narrow approach that a lot of guys have to health where they think is any one.
Simple thing or hey, I tried keto for a week and I haven't lost a, haven't lost a pound, you know? Is that sort of thing that it's helping people? Understand that there's a lot more involved is a complex system and we need to treat them as such. You mentioned that you were having some of your own health concerns and that kind of sitting down a different direct trajectory, as well. Was that the Catalyst for you?
Or were you just seen enough of these patients come in that that alone was motivation to change course. Yeah. You know I was I was kind of blind to my own health you know I was so focused on my career and taking care of patients I was probably working 80 hours a week and neglecting my own health you know I'm operating every day saving lives but I'm actually neglected my own health and the process And I woke up one day without even realizing
what had been happening. I was like 30 pounds overweight and I felt like crap had no energy. I was anxious all the time. I was stressed out. I felt like crap and you know, my wife says, you know, what's wrong? You know, you seem like things.
You know, something's not right? Like, things are off not sleeping well, and I realize that I'm like the typical guy that I'm seeing every day and I had to, you know, really accept and acknowledge the fact that number one was, All my own fault, you know, through your neglect. But number two, here I am. As a men's health expert, a urologist with your 20, plus years of medical training and I didn't really know what to do either. I don't really know what to tell myself to do.
And so, you know, I knew about prescription medications and and imaging tests and surgery. And the typical traditional disease model, medical world that we were taught, but nothing about all of these areas of Health that are so incredibly
important. And it really drove it home for me, when I went to see a concierge doctor here in town and I'm in Sarasota, Florida. And I went to see a concierge doctor colleague friend of mine and he had nothing for me he's like yeah you just need to eat better, eat more vegetables and you know exercise more and lose some weight and be fine and don't get a girl as don't get better when they push on a Statin. And I knew I needed help.
I knew something was wrong. I knew that that this is kind of a wake-up call for me, and I had no idea what to do, and clearly he didn't either. And so I started studying and researching and I learned about epigenetics and I went through a certification program called appear on human performance. Epigenetic coaching program, led me into functional medicine. That led me into peptides therapy, home automation, courses. I'm probably taking seven different certification courses and programs.
At one point all so that I can better my knowledge because I became obsessed with this whole new world that I had never learned through all my Decades of traditional medical training. And so I was able to really so all these various disciplines together integrate them into a way that was applicable to me personally. And I was able to really completely transform my health and got to the point where I felt amazing and I look damn good.
And I realized that I had found Found a great solution for men who were in my same situation and so I started sharing this this kind of multidisciplinary comprehensive integrated if you will approach to Men's Health and my medical practice and it started really working and I started seeing more and more results and I realize I was onto something. And that ultimately led me to make the massive leap of faith and step away from traditional medicine.
And open a gap Institute last year and never looked back. I love it, man. I feel like, I feel like any of the best, you know, inventions the best in any of The Cutting Edge stuff that I feel like I can really get behind all stems from somebody that's trying to scratch our necks and scratch your own itch and fix your own problem.
So, I feel like when you have this self motivation to fix your own issues, that becomes something much more profound than it would be, if he were just, you know, going through the day-to-day and trying to solve some Act. You know problem of somebody else's. Yeah. You're exactly right. Yeah and and you know for me I want to get too deep philosophical emotional but I had a che childhood to say the least and didn't have a father figure there.
And when I first became a doctor and we had to choose what specialty were going into, there were certainly no sir, no accident that I went into Men's Health so that I can really help, you know, focus on on men's health issues. And here I am now as a father Two little amazing kids and have a beautiful life and for me, it suddenly became super personal that, you know, what do I got to do?
So I can be the best dad in the best husband that I can be and everything is aligned now towards that common goal for me. And and I, and my patients can relate to that as well, because I understand them in that sense. And that's, that's what it was all about week. When it comes down to it is your legacy and as a parent, how can you raise your kids to be the
best of a committee? And so, It all kind of come full circle and has some real personal intimate meaning for me. No, totally totally agree, man. What let's touch on that. You know, we can, we can dive into that little bit of a segue here when it comes to Parenting and, you know, having a solid relationship with your kids and your wife, and having a, you know, being a good role model for for them, what do you feel in your own life has led?
What's been the vehicle for you to have that sense of fulfillment and know that you're on the right path for them? Was it because of what you've been able to do and create with the business is it? Because of Else. Like what does that look like for you? You know, I call it living with intention living with purpose. It means that, that everything I do is in alignment with my
bigger goals, my bigger purpose. So when I work with guys and I have a comprehensive program and one Performance Health program, and one of the first things we do with guys is the same thing that I do is I focus on what is my y You know, while I wake up everyday, what's my purpose? And once I identify that, I write it down and it's in my wallet. And I look at it every day and I think about it and I focus on it. So that everything I do is in alignment with that bigger purpose.
And so whether decisions about alcohol or nutrition or sleep, or Fitness, or even down to supplements or mindset work that I do meditation, breathing, exercise. Everything I do is in alignment with that ultimate, they why? And the way I see it is when you have Clarity around your, why? It makes every micro decision that we face on a daily basis. So incredibly easy because it should all be in alignment. And so, for me, that's what living with intentions.
All about total agreement, I feel like, I feel like we can totally dive in the philosophical Rabbit Hole here, but I feel like I just got done recording a podcast and somebody else to show, and they were asking me a similar question. And I pretty much gave this Means that you just gave but you got to have some intentionality and purpose in your life. Otherwise you're literally just going through the motions and I feel like so many people you can do all the bio hacks in the
world. You can have your keto diet optimize you can do the Blue Line blocking glasses. You can have the hormone panels of an 18 year old guy. I mean you can have everything dialed and perfectly but if you aren't excited about what you're about to wake up and do that day, you're pretty much screwed no matter what, right? Exactly so yeah, we're speaking the same language there.
When it comes to all these different bow hacks, all these things that you've learned all these environmental factors.
What would you say like for you? And just for your clientele base, if like, if you were to give, if you were to pick somebody off the street, like the the stereotypical, you know, middle-aged guy that's you know, going through all those heartaches and you know, overweight got the beer belly, Low, T Lo everything, and you were to just throw at him a classic 80/20 analysis of what are the big, you know, things he could do? Implement today that would have
the most profound impact. So as not to lose him with all the details, what would those be? Yeah. Number one without question would be sleep. Yeah so when we when we think about sleep it I think it's valuable to consider it the time during which your body is really rebuilding its repair and
rebuilding recovering. And when we're training, when we're doing a heavy intense workout, we're not Building muscle, you know, this, most people know this, but it's a common misconception that when you're training, you're building muscle, you're actually not, you're tearing it down, you're stressing the body creating a hormetic effect and tearing down or stressing muscles. So that while you're sleeping, you're actually building muscle. And so that's one.
Aspect of sleep is so important. The other part of it is the quality of sleep. So there are various stages of sleep. There's there's already I'm sleeping in there. Stage 1 and 2 which are called light sleep. And then stage three and four, which are deep sleep, that deep sleep, which tends to happen
more in the later. Half of the evening is when I'm sorry to interleaver, have eating Sydney Ariana's later in the evening, deep sleep is when you tend to have most of the repair effects, and that's really critically important part of sleep. And so, that's why I emphasize quality of sleep more than quantity. When you don't get it enough, quality sleep. And you, when you lose out on that deep sleep, Up in the REM sleep. What happens is that raises your
stress hormone called cortisol? Well, what is cortisol do cortisol? The stress hormone and in short term, short term, situations, acute situations. It's good for you, it's helpful. Helps you deal with whatever you're facing but long-term chronically elevated cortisol from from from poor sleep, that causes you to store fat. It crushes, testosterone, it crushes, thyroid crushes, all your other hormones, it breaks down your gut lining.
It called secretory IGA, which is the lining of your, of your gut. And then that allows food antigens to come in with Chris an autoimmune response and then you have this inflammatory effect. And so it promotes all of the bad factors of Health that we look at insulin resistance oxidative stress catabolic, physiology and chronic inflammation. All stem from chronically elevated cortisol, which can all which can originate completely from crummy sleep.
So when I die scientifically into the into the basis of it suddenly you step back up 30,000 foot view. You realize why shit. I got a good sleep and so it did for sizing sleep hygiene is emphasizing. You know, what exactly are you doing in the evening those three hours before you go to bed? What are you doing? What's your behavior is how you setting yourself up for Success. It still had one single thing that I would emphasize it be good. Quality sleep.
I like and I feel like that's something that we all have that we all inherently know, Sleep is important, but we always put on the back burner because we don't. I don't know why we do that. I don't know why we, as a species often, you know, put that as a lesser importance like, I think slick. Yeah portent it obviously is I'm I'm not always good about getting enough quite asleep because there's some things that and I just I put a hybrid, like most of us do. What are some specific tactics?
Do you use like melatonin that to to try and set yourself? At the stage for sleep or do you just have a really rigid? Yeah, great. No, great question. I taught her teens. Yeah, so first of all melatonin there's actually genetics, there are a number of polymorphisms associated with how your body responds to know to know whether it's going to be effective or not with you with you would
benefit from it or not. If I do use note on which is not with everyone, genetics helps guide that, then typically a very, very low dose is all you need of melatonin. But what I find Is a lot of his behavioral. Like you said, we tend to sacrifice it by choice. We tend to intentionally, stay away, you know, working on a laptop, doing other doing other stuff, rather than prioritizing it. And so, when we talk about sleep, hygiene it, for me, it's it.
First starts with having a very rigid schedule, and so, I have an alarm on my phone at 10:30. It's all over, it's done. I don't care where I am. I don't care who, you know, life and I have been watching the show. I don't care if I'm I'm doing work on my foot on my computer, I'm kind of having to look in social media. Everything ends at that point, it's all over. And that's that's really the sounding Bell.
That is bad time and so 10:30 everything stops and I'm in bed lights out and your body needs that very consistent Rhythm from your circuit. You actually have genes, you have color called clock genes in your, in your brain that regulate your circadian rhythm and it needs that consistency. And so creating it on a daily schedule where you going to be the exact same time every day. 7 days a week is Paramount. Next is, what do you do in those three hours beforehand?
I really emphasize that any kind of blue, light, exposure can crusher, Sleep Centers. I have a lot of clients who use block and glasses. That's one option. I think that those are not 100%. So I typically recommend for those three hours, there's no laptop. There's no iPad, there's no phones. And if you're going to watch TV, that you really stopped at least
an hour before bed as well. And that point you have a couple things you can do. You can meditate, you can do breathing exercises, you can read or you can have sex, any of those are great options before bed instead of any of those electronic devices. Yeah. When you do go to bed, has to be a completely dark room. Absolutely no light at all. The light can shine through through your eyes and affect the quality of your sleep as well.
So, The dark room at inclusion alarm clock, that includes Night Lights, anything like that. Very cool room. We know that sleep is better with, in cooler temperatures. So turning the AC down, obviously, super comfortable bedding, is important one. That a lot of people haven't heard of, is you want to keep your phone away from your
nightstand. So EMF is something that is real and it can crush your health crushed or sleep and EMF comes from your Phone, whether it's Wi-Fi, or cellular signal, it's coming from your phone studies show. It actually come from the electrical outlets as well to some extent, but much higher output from any electronic device like your phone laptop. Etc. So specifically keep your phone across the room. I recommend turning off the Wi-Fi throughout the house at
night as well. Some people recommend turning off the power completely in your room with the circuit breaker which is certainly aggressive. But but that's why is really to eliminate that Enough exposure overnight as well. What about a lot of us? Also, what's that about? Cause I feel like people directly being - swirling on health, but from a sleep standpoint, like the indirect adverse effects that come to, your sleep from alcohol consumption, is pretty profound. Absolutely.
Yes, a bit next. Let's look at what you eat and drink. So alcohol, definitely crushes. Your sleep. Now, a lot of people will say, no, I have a drink just to put me to sleep. No sleep doesn't give you good quality and I'm sorry. Alcohol, doesn't give you a Already asleep. Alcohol will sedate you but you have shitty quality sleep. You never get into deep sleep, the entire night when you drink alcohol. And so it's really important to
know that it's a sedative. Yes, it'll make you, it'll make you fall asleep, but you don't get any quality of sleep and that's why whenever you drink it, you you may notice that when you wake up the next morning you don't feel well rested. You don't feel like you got the any good quality sleep because it messes with you, to the point that you never get down to those those stage 3 and stage 4 layers of deep sleep.
So alcohol crushes, you the same thing with with Lunesta and being those other prescription medications that are used for Sleep. Same thing they will sedate you but but you don't get the good quality sleep. It's a very different type of sleep when you use any of those products when it comes to food food and definitely affected as well, about what we get a little anchor. So apologies are what about cannabis, like talking about the
alcohol and its effect on sleep. A lot of people are smoking. A big old do before going to bed? Is that having a Adverse effect on them. Yeah, you know, I haven't actually honestly have not seen the data on cannabis as a relates to deep sleep. So I couldn't tell you, I would imagine they're somewhat alcohol but also had, I have not seen the literature on that.
So I don't want to own a Miss bacon and say that, but I think that in general, what you want to do is not become dependent on any substance, drug product, Etc, to put you to sleep. And at that, if you're using it for that purpose, then I would, I would suggest you do everything you can to get off of it, just for that reason alone, but I wouldn't be surprised if it pushes deep sleep. I just Tell you for certain action, make sense? Yeah, yeah. Looks the same foods are big one as well.
So basing, your genetics, there are a number of poly more Gene, polymorphisms, genetic variants, that can potentially cause you to respond poorly to certain foods. So, freezer the high in glutamate. So things like proteins, things like soy, things like chicken, a lot of foods that are high in glutamate. It can potentially cause issues with falling asleep.
So why is that? Well, normally your brain converts glutamate which is an excitatory neurotransmitter into Gaba gabaa, which is a very calming soothing relaxing neurotransmitter. Well, for people who have certain variance of that Gene that we're talking about, it's glutamate is the Gad one genes, which equipment decarboxylase they can't convert. Eight into the calming Gaba. And so they get X is glutamate levels. And that's again a very excited to receive emulating or
transmitter. And so for certain people who have those variants, we want to really be careful to avoid foods high in protein even losing a grains for example while glutamate as well. You want to avoid those Foods in the evening knowing that they could potentially affecting the quality of your sleep. Gotcha.
And now it's interesting, I've had several clients and most of my clients Ants are trying to avoid eating right before bed but I'll go one step further and try to see have them experiment with not consuming. A significant bowls of protein right before bed or if they do, so try and have equal parts fat with that meal, as a way to kind of help slow the absorption of that protein. I feel like if they ever have like, just a massive bowls of pure protein before bed, like
chicken breast or shrimp. For instance, they almost invariably don't sleep as well. Yeah, there you go. And it could very well be this glutamate Gaba issue, for sure. Yeah. And so I really I really recommend that. You try to go to bed on an empty stomach. Anyway, you know, that's the time where your gut needs time to recover to heal. And so we talked about, you know, cycling your meals. You know, we talked about intermittent fasting that sort
of stuff if you want. But I really try to get guys to eat more earlier in the day and really stop, you know, like for me it's 6 p.m. so I'll go to bed. 10:36 p.m. is when I stopped eating every night and so it gives my body, you know, good for hours and metabolism. Then digesting without any added stress. After that, I'll point out, is that one of the, the key hormones that are that, it's intimately tied with sleep and growth hormone.
And as we get older growth hormone, declines, naturally, and that could potentially have a real effect on sleep and thyroid would be the same thing. I've had a lot of women especially with our so men, but but I'd say more often women who have significant issues with sleep and when we correct your thyroid hormone levels that issue completely resolves.
And so it could often be hormones, growth hormone, I do a lot of work with peptides therapy to help boost natural growth hormone production and that will have a dramatic effect on sleep. First, and foremost before, anything else. I feel like peptides. I mean, correct me if I'm wrong here. This is your will has not mine, but I think that's kind of like the one of the the New up-and-coming Frontiers when it
comes to optimizing. Is there seems to be like a wild west associated with its right now. It seems Well, you definitely use the right phrase there while Wes is it, unfortunately, how it's become, so peptides are truly amazing molecules. They're signaling molecules that are by already recognizes because they're derived from enzymes that are body creates or create at one point and they can be used for very precise purposes. So for example, I mentioned there peptides that help Booth
your boost. Your body's growth hormone production, there are peptides that help. Immune system through, you know, the thymus gland is in our neck, and when we're very young, it's intimately involved in our and the maturation of our immune system and that gland, shrivels and atrophies and that gland is gone and adults. Well, peptides derived from the thymus gland are very helpful at boosting our body's immune function specifically teeth.
Cell function. So that's a great use for peptides peptides for musculoskeletal repair for reducing inflammation, whether it's in the joints, or in the gut or systemically are peptides for very specific purposes, the problems that have called from this, is that when I prescribe a peptide, it comes from a compounding pharmacy. I have quality assurance, I have certificates of authenticity.
I know that it's being monitored and I'm A spot with the purity of those products when I prescribe them, right now, you can go through several sites online, direct to Consumer site that will sell you peptides. And that's what a lot of guys are doing. And for me, that's really a big concern because I just, I don't know what the heck they are and what the real or not. I don't know if they're legit. I don't know if they're tainted. I just have no idea.
The quality and and so it is in a sense. What you said, the wall West has gotten a lot of control now where there are a bunch of companies out there selling
peptides and and it's a concern. And these compounding pharmacies like like compounding is is no small feat like there's so much variance that goes into compounding these formulas and if you don't have that dialed in but with a lot of these like topical treatments especially like you can totally and drastically change, what your hormone levels are and you wouldn't really know if you're getting these from a non reputable source. Yeah, exactly.
Right. You you got to be careful that you know what you're taking and you know your body Rekha. If it's if it's properly synthesized it's a very specific amino acid sequence and its alternate anyway you have no idea what those effects are going to be. So what is like pull the curtain back on. What your company does. Exactly like if you've got to look like a clamp that comes in there dealing with performance issues in the gym or in the bedroom and they just don't feel
optimal. What is that like what does that play by play look like in getting them fixed up. Yeah, so great question. So, the first thing we do is as part of an I've created what I call the N1 Performance Health program and I called it in one specifically because And of 1 or n equals one as a phrase that we use in medicine that refers to individualized and a clinical trial of just one person.
Because we understand that we're all individual, and your health needs to be addressed that way as well. So, first step in the program is we take a deep dive into a health assessment, and we really understand lifestyle and behavior is activities and social connection. And you know, medical history were to be tried before, which worked. What hasn't worked? What are your challenges wonder? What's holding you back? What's getting in your way? What if you try before, what has
and hasn't worked? And what are your goals? What do you want? And I think this is really worth taking just a moment just emphasize here. So a lot of guys will come in and say I want to lose 20 pounds. Well, my question is why and they'll be like, yeah, I want this one pounds, get you? Just because I have my belly's that, you know, when I don't be so fat, but but why? Well, yeah, because we don't, I want to pass to fit. No know. Why is it? Well, you know, I just I don't
like the way I look but why? And so that's a big part of it is really getting getting intimate with with my clients to understand. What their, why is, what are their goals. And a lot of times it's around intimacy with their partner, or feeling loved or feeling connected to someone or having a better relationship with their
family in some way. So it there are superficial um goals and then there are deeper really more meaningful goals and I think it's important to really hone in on those important. You know, substantial goals, if you will go to war, If we do that, we then choose the appropriate testing package and all patients undergo genetic testing. So that's the simple cheek swab and were able to get 750 thousand genes that we look at and develop some understanding of them when we look at nutrition.
Micronutrients sleep, detox Fitness and hormones. So six general areas that we look at in genetics. We do very detailed lab testing so this includes blood testing where we're looking at. Um, probably 20 different hormones. We're looking at a number of markers of inflammation. Number of markers of metabolic health and and, and glucose metabolism looking at massive panel. That looks at cardiovascular risk factors, you know, most doctors do cholesterol LDL HDL.
And in general, those are fairly worthless, believe it or not and we'll look at a lot more detailed information than that like April be and the NMR fractionation of particle count and stuff like that. We dive deep into that stuff. We do a lot of functional testing as well, so we do microbiome testing. So microbiome is what we call the bacteria in your gut and your gut actually controls almost every part of your health. And it's something that's that's kind of foreign to most people.
But the bacteria in our gut, they control our metabolism, they control our neurotransmitter production, they control energy or move it control our immune system and So, it's really important to understand the microbiome. And if it's off, if there's an imbalance in bacteria, if there's any signs of inflammation or breakdown of the gut lining or candida, or other infections, microbiome is really a key part of that assessment. We look at Food sensitivity
testing. I've had a number of guys come in and they've had gut issues. And then food, sensitivity, testing shows that there are certain foods that are causing problems and and that can have an instant effect on their health, just buy it. Eliminating those those specific Foods. We also look at cortisol testing, so I mentioned earlier how stress can have a big effect on your health and that stress can come from psychological stress but also stress from poor sleep or stress from chromium
nutrition or stress from toxins in our environment, you know, stress from wherever it may be. And that chronically elevated cortisol. Eventually becomes low cortisol, and understanding your cortisol levels are really really important, especially when it Students health. So we look at that, we look at organic acids in any case we're going to gases are really markers of metabolism.
If you will to look at how our body processes that the main macronutrients Cardinal carbs, proteins, and fats, and it looks at every step of glycolysis and the Krebs cycle and other other steps gluconeogenesis other steps in metabolism to understand where there's a bottleneck or where there's a problem or you know why your mitochondria not working like they should So we do all this comprehensive testing and then we put all this together and create a very detailed blueprint
and that includes genetic blueprint a lifestyle. Blueprint medical blueprint always based on their challenges, their goals and all the test results. And my guys work with health coaches, functional medicine drain health coaches because, you know, lifestyle and behaviors and accountability is so important.
With the medical team and we will prescribe various hormones in supplements and peptides and whatever you may need on an individualized basis and will be tweaking that on a regular basis throughout the program. How often are you typically doing repeat? Lab work to see how the prescribed peptides and hormones are impacting their Baseline markers? Yeah, great question. It really depends on what we're looking at.
So if we're looking at things like testosterone that that needle moves very quickly, Lee. If we're looking at things like apob or looking at other markers, it may take a lot longer fasting insulin. For example, I'm not gonna look at that every month it that maybe every three months, for example. Yeah, some lousy we look at only once a year, some labs are every month. It really just depends on the individual, depends on what labs
were dealing with. You know, the guy has high uric acid levels which is typically a sign of poor, metabolic Health, only be checking in that regularly. You know, things like hemoglobin A1c. That's a Marker for Diabetes Type 2 diabetes, especially in these men. That's not one you're going to check every month because you don't care as much about that. As you may have other more important markers of metabolic Health. Now, a lot of these, these ideal
windows are there. Different like you go? Like if somebody gets like, I go to various different place, to get my lab work drawn and when they gave me the printout of what the ideal range should be. It's always different. There's not like a standardized ideal range, it seems. So when it Comes to like a guy's testosterone panel. For instance, is there like a deal window that you would like to see the vast majority of your clientele fall with him?
Yeah, great question. So this is something I talk about a lot so glad you brought this up. So I would emphasize that when you look at your Labs that range that you're talking about on the right, I want you to just to look at the top of any lab page and you'll notice that that range is called reference range. It's not Normal range ideal range optimal range. It's not, it's called the reference range. And so that leads to the obvious question will, what's the reference range?
What does that mean? What that means is that lab has taken millions of previous people before you and simply average those results. And they look at what is the statistical average, or median of all those labs. And then you look at 2, standard deviations above, and below it. And that gives In your court, reference range, think of the bell curve and basically taking, you know, 95% plus of the
population in that range. And so that's how the reference range comes up. I was developed that the big problem here. That is worth, really emphasizing here. Is there were three longitudinal studies published worldwide one here in the u.s. called the mail. Massachusetts aging study, what was in Sweden and was in Finland, you can look this up on PubMed. All three of them looked at 20
plus years of testosterone. Our own data worldwide and what they found, all three studies remarkably showed the exact same thing and that is that free testosterone. Get this has dropped 45 percent in the last 20 years. So, let me repeat that free testosterone levels. Worldwide have dropped 45 percent over the last 20 years. What that means is a 50-year old guy. Today, has a free testosterone that is almost Half of what it
was 20 years ago. So, understanding results of those three studies showing that worldwide levels are plummeting, which I believe is mostly from toxins in our environment by the way, but we know those levels are plummeting and so now go back to your lab slip and think about that reference range and think about what that reference range was 20 years ago compared
to what it is now. Yeah, it was about 50 percent higher and so when you think of where you are in that range, now it gives you a whole different perspective. Did that not only are you is your level not necessarily optimized or ideal or good? You're just in the bottom of this excuse my language shitty average that we have now that
people are accepting as okay. And so that's the real problem is that it's very misleading to have this, this, this massive reference range, that's honestly a joke. And so some Labs, it may say, you know, total testosterone like 195 to 700 or or 210 to 800. It's That's all, it's ridiculous.
So what do you want? What's ideal a total testosterone in general doesn't mean much because the way to Stossel works is it has to get into the nucleus of the cell to affect transcription, which means basically means the DNA, producing enzymes and proteins to have its outcome or its direct result for testosterone to get into the nucleus of the cell. It first has to get into the nucleus has to get into the cell itself and to do that, it has to
be free floating. Can't be bound any proteins in the blood or else it cannot get into the cell to do its job. And so that's what the word free testosterone means. It specifically indicates testosterone molecules that are not bound to proteins. And are thus bioavailable which means it's able to get into a cell to the US, get into the nucleus and have its effect. And so, when we look at total testosterone, you can almost think the total testosterone as
your army of soldiers. And the free testosterone is the soldiers. You actually have guns so Julie actually do anything accomplish anything. Yeah. And so I don't really care too much about your total testosterone. I'll give an example of what I mean by this.
We care about free testosterone and we want to free testosterone depending on the scale and depending on whether it's calculate or measure, there's no the key thing, some Labs will calculate based on on looking at total testosterone, looking at shbg and I'll be minute, I'll give you this ballpark number, which may or may not be. Accurate versus directly measure, which I would prefer the measure range. You want it around 200 and that range to give you an idea.
It'll say, I think this is like, 62, 225 is the range and you wanted 200, 250 or so. It was a goal for total test for, excuse me, for free testosterone, some other labs, that may be up to 20 up to 25, in which case you want to be 20. So, depending on your lab is either 20 or 200 depending on the Range that you're looking at. I'll have guys, that will have a total testosterone of 600. And they're free is 185 or I can have a guy with a total testosterone of 12:00 and their free is 185.
And so you can see how the total can vary quite a bit, but it's the free that we really care much more about, and that's really the goal. So, when you're looking at, you know, what's ideal or optimal is, you really want that free testosterone to be up near 200 250 or so?
In, that example, of a guy that's got a total testosterone at 12:00 and a free of 185, he's probably Got more toxins, more estrogens, more sex hormone-binding Goblin in his system than the other, so that would probably be more of an environmental fix than anything, right? Well, you're right that he definitely has more shbg because that's what's binding up all the testosterone to make that the ratio different from the god of the total of 600.
Yes, he has much higher shbg and a lot of genetic space-time. A lot of it is based on some resistance factors. And guys are always asking, well, you know, what can I do to lower my shbg. So I can get a higher free testosterone ratio and it's fairly tough to do. Stinging, nail root is One supplement has been shown to have some benefit in that regard. I've seen some stuff on Boron. I don't think it's very effective. I don't think the data is really
strong there. Psalms selective Androgen receptor modulators will make your your shbg plummet down close to 0, which you would think? Maybe that's good but we really don't understand the long-term consequences of that. So I don't ever recommend that. Typically some guys, we just need to accept the fact that their total testosterone is going to have to be higher to account for that high shbg. Gotcha. Gotcha. It makes sense. Yeah. What are the best there?
Any other you kind of you kind of went over them here but like for me just to give you some context. So I competed natural bodybuilding, I can't use arms, I can't use peptides. I Use anything? I mean they're like crazy strict. So what are the best natural ways? Like are there any legit supplements? I mean talking about boron you talk about stinging nettle like
is there anything? Apart from just fewer environmental toxins better quality sleep and mindset that I can do or my pretty much just sticking to the basics? Yeah, I mean you look at what's the, what's the foundational Basics that I would recommend for every mankind? You know, I get that question a lot. Like, I think kind of answers your question, you know, number one vitamin D. She has a lot of effects on your body and so making sure your vitamin D levels are optimized.
So most guys are defeat even here in Florida where I am, you would think that Sunshine State. You think, the vitamin D levels are great. I see guys every day who are in the sun and the levels are still like 20. And so and the goal for that is 60 to 80 is your target for vitamin D levels and so most guys need Vitamin D supplementation. Even though bioavailability, maybe poor, you still Need it because some people just genetically they won't convert sunlight into enough.
Vitamin D, that they need some vitamin D is important. I love something to help with your face to detox. You know, a sulfur containing supplement, like, you know, NAC or something like that to help boost glutathione levels. I think this is really important, especially given the fact that we know that toxins are everywhere.
So supporting glutathione function, fish oil, you know, we could talk about omega-3 versus Omega six and I know you're He focused on this in the past but anything we can do to help that lower that Omega 6 to 3 ratio by fish oil, I always recommend. I think there's some honestly be a studies out there that say fish oil doesn't work. Well I think again understanding a systems biology approach to health that we're looking at a lot more than any one specific barometer of that.
And we know that if you look at, you know, what are the poisons that we need to avoid? Only its number one sugar. We know that number two, that's not often recognized our seed oils, the sea levels of vegetable oil was consumed. Little sunflower, safflower oil, peanut oil, all these oils are full of omega-6 polyunsaturated fatty acids, which are
pro-inflammatory. And so, you know, if you're trying to burn fat, trying to trying to get a six-pack trying to lose visceral fat and build muscle, you'll never do it. If you can't fix that Omega 6. Ratio. And so that involves number one lower and omega-6 fatty acids by by eliminating intake but then also increasing omega-3. So I love fish oil, you know, good quality multivitamin, of course, make sure you're getting all the, the, the B complex vitamins, based on organic acid testing.
A lot of guys do need additional B vitamins support. I think it was thinking. Magnesium levels are important,
as well. What else have you seen any correlation like when you're when you're working with your clientele and you're asking what their diets like have you seen any like when you rule out all the people that are following a standard American diet, and just eating everything crap, and you look at the extremes of like, a plant-based diet, versus an animal-based diet, like vegans versus carnivores. Like do you see any common patterns there with regard to
overall hormonal health? It's a good question and you know it's such a it's such a crazy world.
When you look at the nutritional battles that are out there with all the you know the carnivore versus paleo keto, vegan plant-based, you know there's so many different approaches and you know what I have seen honestly that's just anecdote, that's just you know, small cohort a pot, you know small population and and I think it's worth really emphasizing you know whatever my data is. I'm Going to share because it's irrelevant because you got to understand and for so many
variables that we can't even account for. Hmm. So a lot of these studies are out there. You'll see a study every day where it says, oh this study shows a plant-based socks or Quito. Is the only one you need or paleo is where it's at or this or that the problem is, there's so many variables you take a population who is purely Quito.
Well they're doing a lot of other things right as well, that means their doll in so tightly into their nutrition, that means They're working out every day as well, they're incorporating strength and fitness and strength and interval, and endurance training. That means they're getting a good quality sleep there, mitigating stress, they're doing, you know, mindset were good.
They're taking supplements or doing all the right things you got to do. And so to compare that guy to another guy, it's impossible to account for all of the variables that come into play that any of those population-based observational studies are crap, and you just can't make They
getting out of them. And so, I think a lot of it is individualization, a lot of it is figure out what's right for your body and what you're going to, you know, first of all, what you gonna be able to do consistently, what do you like? And what you going to stick with long term that you can
incorporate into your life? You know, socially that you'll be able to do. I think that's what it's all about and then focusing on all those are aspects of Health that we've talked about and and so long answer to your question. I don't have any specific nuggets. They'll give you on one group versus the Other. I think it's putting all those pieces together and I think that it is it is possible to succeed with whatever specific diet you
choose. If you dial everything else in together with it. You know. That's a good safe answer for sure. Yeah. I could have loved some feathers wrong way, with that one, for sure. Yeah, awesome. An awesome. Well, what else about? Like, when I get sent your, your bio, your headshot and everything, you're also The Man Behind the gains wave brand, right? Yeah, so I'm a gay slur provider, so yeah, I think that's how we got connected. Actually, you're right.
So I think it's worth at least mentioning that. So I do a lot of work with Men's Health and as I mentioned, one of the key things that will drive a man to finally seek medical attention is sexual health issues. And so, a lot of the men we work with other Gabon Institute they're coming in for, you know, sexual performance, whether it's erectile dysfunction, or they just want to have better performance, or it may be a little be do or the other health
issues we've talked about. And so Gaines wave is is a type of low intensity, Shockwave therapy to the penis that has been shown to dramatically improve sexual function by increasing blood flow. And so for men who are having issues with poor blood flow, it's a great option in a very non-invasive way to help improve blood flow and help them restore function Gadget. You can see one of my best friend's is in the Space Dandy Vega. He was sponsored by games wave for a while.
So Had all these podcast coming out talking about? Yeah, yeah, yeah. So I thought I saw your headshot and bow and everything come through. So, I instantly recognized that and that's something that I feel like a lot of people, like, a lot of people just simply don't want to go the route of, you know, exotic as hormone therapy for whatever reason for Right Reasons. Wrong reasons. So having an option that's available to them, that's totally non-invasive in that
regard. Yeah. Is it sensible thing to go for sure. Yeah, absolutely. I think it's it's important to. So, to point out that it's a non-invasive treatment is painless, it is, it is really one of the only ways that we have available at our fingertips today, to actually reverse the underlying cause of e.d. So, there are in general for cause of e.d. There's poor blood flow, you know, lack of arterial inflow. There is nerve problems.
Which typically come from either pelvic surgery, like prostate or Surgery or diabetic, neuropathy or other types of neuropathy issues, spinal, cord, injury, brain, tumor stuff like that. Third would be hormone issues so low, testosterone it would certainly apply to that issues with thyroid DHEA, cortisol insulin. Any of these other hormones can
also cause that. And then finally the for the psychological like, you know, marital issues infidelity porn addiction stuff like that, that couldn't psychologically getting away. But most men, we see maybe as many as 90% of them. It's because of arterial insufficiency, poor blood flow and that's where gains weight of it is really the only non-invasive way that we can reverse that process by activating stem cells to create new blood flow. And so that's why I'm against a
provider. I think it's a great treatment as long as you choose the patient carefully, you know, make sure that you're selecting the right treatment for them. I mean, I'm assuming that technology Works throughout the entire body around like you can you could in theory use this games with technology. Get better blood flow on your biceps or something, right? You know, it is so low.
It has a shock wave. Therapy has been used in other parts of the body, I know for sure, I don't know if the studies out on using a specifically a on muscle to build to develop blood flow. Like, you're like you're saying and I don't know, that would be better than simply exercising, strength training, that muscle. That is actually something worthy of a study. Actually, that's a good idea that games late for the bicep, man. There you go, yeah. Awesome man.
Awesome. Well, what, where do people go to find out? More about you, dig deeper, and just learn more. Thanks so much. So I'm a Said Gap in Institute.com, and I'll offer your listeners. A free gift if they want to text the word to health, the, to six seven, eight, six. Again, that's the word Health, two to six, seven, eight six. They will get a free copy of my 10 secrets to high performance.
Health will also get a complimentary copy of my best-selling book, male 2.0, get a digital copy and then also get a link if they want to jump on a call with my team to see, you know, if we can help you with your health issues. That will be on there as well. Awesome.
And well, first of all, I want to congratulate you for really providing a lot of context and Clarity around all the environmental factors that the toxins just the lifestyle design, because I feel like so many of these clinics, and every time I've had somebody on the podcast that talks about improving, both male and female, you know, health and performance and vitality like so many of the compass.
So many of the competitors out there they're just so quick to write scripts and you know peddle drugs and I feel like having having people in the pond Cast and having people in general that are out there that are talking about all the lifestyle factors, which I think is probably the most, you know, Paramount discussion to be hand. So, the fact that you're really draw attention to that first and foremost, man is awesome. So, keep doing that for sure, I appreciate man.
Thanks so much. And yeah, enjoy the time of the year today. Yeah, like wise man, will definitely keep in touch and talk soon. Brother, you got it? I think so much.